The Greatest Sabotage to Obamacare is 'Medicare for All'

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.

February 13, 2019 - 15:46 — Elizabeth Wright

Today the House Energy and Commerce Subcommittee on Health held a hearing entitled, “Strengthening Our Health Care System: Legislation to Reverse ACA Sabotage and Ensure Pre-Existing Condition Protections.” The irony cannot be lost that Chairwoman Anna Eshoo (D-Calif.) was a co-sponsor of H.R. 676 in 2018, “The Expanded and Improved Medicare for All Act,” which would be the ultimate sabotage to the Affordable Care Act (ACA), or Obamacare. The bill would have created a government-run, single-payer healthcare plan, replaced ACA, and would have eliminated all private insurance, including employer-based insurance.

The hearing discussed four bills, offered in the Democratically-controlled House, that would derail the good work the Trump administration has done, which is allowing states to stabilize their individual healthcare markets. The bills would rescind the Trump administration’s Section 1332 waivers guidance and rule changes, restore funding for Obamacare navigators, reverse the rules that allowed short-term, limited-duration (STLD) insurance plans to be extended for longer period of times, and implement requirements to disclose the risks of STLD insurance plans.

CAGW discussed in an October 2018 blog the outstanding work the Trump administration has been doing with Section 1332 innovation waivers, a provision found in ACA, that returns power back to the states, providing more flexibility to come up with novel ideas to stabilize their health insurance markets and drive down premium costs in their states, while still protecting people with pre-existing conditions. Utilizing the 1332 waiver process is completely voluntary and states are starting to take advantage of this ACA provision. Alaska, for example, has used the waiver process to create and fund a risk-pool that helps patients with pre-existing conditions get health insurance while at the same time lowering premium costs by 19.8 percent, helping to increase enrollment.

Other states, such as Maine, Maryland, Oregon, Wisconsin are utilizing the 1332 waiver process to stabilize their individual markets. This is a good thing. After all, who knows best what their population needs; state government officials or bureaucrats in Washington, D.C.? It is surprising to see the resistance within Congress to this concept. One would think congressional members would have more faith in their states’ leadership to understand what their respective population needs when it comes to healthcare.

CAGW has also been supportive of the changes the Trump administration made to STLD insurance plans. STLD insurance plans do not have to follow the expensive ACA mandates, for example, requiring a single man to purchase a health plan that includes maternity care. The Obama administration had limited the use of STLD plans that provided affordable options for people to purchase health insurance. The Trump administration reversed the Obama administration rules, which restricted STLD plans to only three months in length by extending their use up to 364 days instead and allowing them to be renewed up to 36 months.

It should be noted that providers of STLD plans are already required to notify their customers that a plan does not have to comply with the federal requirements found in ACA and that they should review their policy carefully, understanding it may not cover several essential benefits such as maternity care, hospitalization, and prescription drugs. In addition, because the STLD plans are voluntary and are deferred back to state regulatory authority, states have the option to put on more restrictions or even ban them.

CAGW has been critical of the Obamacare navigators, stating they are wasteful, since the law's inception. Healthcare experts, such as Sally Pipes of the Pacific Research Institute, have agreed with that assessment. The administration was right to cut the funding for the navigator program as by now people know how to shop in the Obamacare marketplaces and navigators enrolled less than one percent of participants in HealthCare.gov in 2017.

Many Democrats have admitted ACA has failed and are now moving forward to get the federal government engrained even deeper in our healthcare. In 2018, 124 Democrat House members, or two-thirds of their caucus, supported H.R. 676, the “Expanded and Improved Medicare for All Act.” In the Senate, 16 Democrats, or more than one-third of their caucus, including several presidential candidates, supported S. 1804, the “Medicare for All Act.” In fact, the term “Medicare for All” became a rallying cry in the 2018 campaign and will be a major issue for 2020.

Today’s hearing demonstrates that the left-wing in Congress is trying to stop the Trump administration from giving states the flexibility and the ability to fix the enormous damage Obamacare did to the individual health insurance market. If the Trump administration continues to succeed in returning power back to the states, allowing them to drive down health insurance costs, it will be difficult for liberal politicians to sell a complete federal takeover of our healthcare.